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Side-branch wire entrapment during bifurcation PCI: avoidance and management
Andrew T Burns1, Jack Gutman, Rob Whitbourn
1Cardiac Investigation Unit, St Vincent's Hospital Melbourne, PO Box 2900, Fitzroy, Victoria 3065 Australia. andrew.burns@svhm.org.au
Summary
A coronary artery intervention was complicated by wire entrapment, requiring snare removal. Successful retrieval of microfilaments led to a good outcome after one year.
Area of Science:
- Interventional Cardiology
- Vascular Surgery
Background:
- Coronary artery bifurcation interventions are complex procedures.
- Managing complications during these interventions is crucial for patient outcomes.
Observation:
- A case of left anterior descending/diagonal 1 (LAD/D1) bifurcation intervention presented with side-branch wire entrapment and unravelling.
- This complication necessitated the use of a goose-neck snare for retrieval.
Findings:
- Residual microfilaments were successfully removed from the main coronary artery.
- The intervention ultimately achieved a satisfactory angiographic result.
- One-year follow-up confirmed the sustained positive outcome.
Implications:
- This case highlights a specific technical challenge in bifurcation stenting.
- Effective management strategies for wire entrapment are essential for interventional cardiologists.
- Awareness of retrieval techniques can improve procedural success rates and patient safety.
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